ALZHEIMER’S DISEASEBY OLUFOLAKUNMI KEHINDE PRE-MD 1

DISEASE OVERVIEW: INTRODUCTION TO ALZHEIMER’S SIGNS AND SYMPTOMS BRAIN ABNORMALITIES RISK FACTORS DIAGNOSIS TREATMENT AND MANAGEMENT PREVENTION

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WHAT IS ALZHEIMER’S DISEASE?• Alzheimer’s disease can be

described as a progressive brain disorder characterized by an irreversible decline in mental activity such as memory, language skills, reasoning ability and perception of time and space.

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WHAT REALLY HAPPENS? Alzheimer’s disease is a

neurodegenerative disease (a gradual process of brain cell death) that happens over a course of time.

Brain cells (neurons) meet at points known as synapses. Tiny burst of chemicals known as neurotransmitters (e.g. gaba, acetyl choline) travel across synapses to other cells carrying electrical signals.

Alzheimer’s disease is known to affect the function of the neurotransmitters (majorly the acetyl choline), leading to learning difficulties and memory problems. 4

DISCOVERY• It was first

described in 1906 by a German Psychiatrist Alois Alzheimer.

• It is the common cause of loss of mental function in those aged 65 and over (late-onset).

• Alzheimer’s disease in people in their 30s, 40s and 50s is referred to as early onset. It is usually as a result of genes or family history.

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PREVALENCE OF ALZHEIMER’S DISEASE

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ALZHEIMER'S VS. DEMENTIA

Alzheimer’s is often mistaken for Dementia.

Although dementia is similar in effects to Alzheimer’s, but dementia is a symptom caused by Alzheimer’s disease.• In a few cases, dementia is reversible if the

cause is quickly detected and treated (thyroid causes or vitamin deficiencies) but Alzheimer’s is irreversible.

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HOW DO YOU KNOW YOU HAVE ALZHEIMER’S DISEASE?

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SIGNS AND SYMPTOMS OF ALZHEIMER'S DISEASE: Since Alzheimer’s disease is progressive, the symptoms diagnosed in early onset get worse as the individual ages.

Difficulty in taking in and remembering new information.

Impairments to reasoning, complex tasking and exercising judgment.

Impaired visuospatial abilities.

Impaired speaking, reading and writing.

Changes in personality and behavior e.g. loss of empathy and social withdrawal.

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BRAIN ABNORMALITIES:

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RISK FACTORS: Risk factors can generally be divided into two: unavoidable and potentially avoidable factorsUnavoidable factors Age: incidence is higher in older people than younger ones.

Higher percentage in 85y and above than 65yrs and above. Family history: family history and inheritance of genes. Possession of the Apolipoprotein E gene or APOE

increases the risk of Alzheimer's. Females are at risk of Alzheimer's compared to

males. Children with Down’s syndrome are prone to

early-onset Alzheimer’s.

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RISK FACTORS:Potentially avoidable factors Factors that cause increase in blood vessel e.g.

hypertension and high cholesterol can lead to stroke (which can lead to another type of dementia).

Prior head injury: traumatic brain injury can increase the risk for Alzheimer's.

Chronic alcoholism

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DIAGNOSIS OF ALZHEIMER'S

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DIAGNOSIS OF ALZHEIMER'S Alzheimer’s is positively diagnosed by

viewing the brain tissue of a patient under a microscope after death (autopsy):

Autopsy shows the build up of a protein called beta amyloid (amyloid plaques) found in between the dying cells causing a plaque formation.

Also, the disintegration of another protein called tau leads to tangles of the neurons.

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DIAGNOSIS OF ALZHEIMER'S Diagnosis of Alzheimer’s disease in a

living patient involves the narrowing down of the possible diseases (differential diagnoses) by a physician to arrive at Alzheimer’s

Doctors can:• take patient’s history • check neurological function e.g. senses and

reflexes• performing brain scans like CT-scan and MRI• carrying out blood and urine tests • asking cognitive questions

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DIAGNOSIS OF ALZHEIMER'S

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Image showing the build

up of amyloid plaques around on the neuron (white-coloured plaques).

TREATMENT OR MANAGEMENT: Since Alzheimer’s cannot be treated the

symptoms associated with it are rather managed e.g. by adult daycare programs

Drug therapy can also be adopted to manage the symptoms and improve the quality of life of the patient. Drugs like:

o Donepezil (brand name Aricept) o Alantamine (Reminyl) o Rivastigmine (Exelon) o Tacrine (Cognex).

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PREVENTION Decreasing the risk of Alzheimer’s by

reducing the risk of cerebrovascular diseases like stroke.

Stop smoking. Reduced alcohol consumption. Eating a healthy balanced diet. Constant monitoring of blood pressure.

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REFERENCES • www.medicalnewstoday.com• Encarta premium 2009• www.alz.org• www.mayoclinic.org• www.nhs.uk

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